A team of researchers from Emory University interviewed 475 gay men in Atlanta, Georgia, who indicated being the insertive partner -- or "top" -- in the previous six months to compare the occurrences of events like condom failure and incomplete use, and the frequency of these events. Before diving into their findings, the researchers acknowledged that the HIV epidemic among gay men in the U.S. is complex and evolving, as are the racial disparities within the epidemic.

Nearly 40% of black gay men reported breakage or incomplete use, around twice the number for white gay men. For the researchers, "incomplete condom use" meant that the insertive partner put on a condom after already penetrating the receptive partner or took it off before finishing having sex; black gay men were significantly more likely to report incomplete condom use. Black gay men were also more likely to unroll a condom completely before putting it on the penis. The correct way to apply a condom is to roll it down over the head of the penis, down the shaft and to the base, making sure that the "inside" of the condom is facing down before allowing the condom to touch the penis.

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Only 31% of respondents (regardless of race) reported using a condom correctly, while 54% reported suboptimal fit/feel of the condom. Overall, suboptimal fit and feel had a loose correlation with participants reporting condom breaks. Also, many black gay men (53%) reported using oil-based lubricants, which are known to weaken condoms, compared to only 21% of white gay men. Overall, 61% of gay men reported erection problems while wearing a condom, with more white gay men reporting erection problems.

The researchers concluded that oil-based lubricant use, as well as fit and feel problems, might account for a considerable percentage of condom breaks among gay men, especially black gay men. They called for the condom industry to design better fitting condoms to address this problem. Better feeling and fitting condoms might not only increase the use of condoms in this population, but also decrease events of incomplete use. Of course, better condoms would also benefit in preventing the transmission of HIV.

Absent from the study was any mention of condom education in schools or communities, whether participants had been correctly, formally educated on condom use and whether condoms were readily available to them. Subsequently, any mention of racial disparities in sexual education was also absent from the study.

What do you think? Do you have any problems with fit and feel when it comes to condom use? Have you ever used an oil-based lubricant? Do you think that lubricants are adequately discussed as a part of proper condom use?

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